关节清理术治疗远指间关节黏液囊肿

Application of joint debridement for distal interphalangeal joint mucocele

目的评价单纯指间关节清理术治疗远指间关节黏液囊肿的疗效。方法自2013年4月至2017年9月我们采用关节清理术治疗12例15处远指间关节和拇指指间关节黏液囊肿患者,术中切除背侧关节囊及骨赘。结果术后1处切口皮肤部分坏死经换药后愈合,其余切口均Ⅰ期愈合。术后随访时间为14~22个月,平均15.5个月,未见囊肿复发和指伸肌腱断裂,患指关节活动范围较术前明显增加,关节活动疼痛减轻。结论采用背侧入路单纯指间关节清理术,无需切除囊壁治疗远指间关节黏液囊肿,可免除植皮和皮瓣治疗,复发率低,关节活动佳,可广泛临床推广应用。

Objective To evaluate the clinical efficacy of simple joint debridement in the treatment of distal interphalangeal joint mucocele.Methods From April 2013 to September 2017,12 patients with 15 fingers of distal interphalangeal joint or thumb interphalangeal joint mucocele were treated by joint debridement.The dorsal joint capsule and osteophyte were removed during the operation.Results One finger had partial necrosis of the incision skin and healed after dressing change.The incision skin of the rest fingers achieved primary healing.The postoperative follow-up ranged from 14 to 22 months with an average of 15.5 months.No recurrence of cyst and rupture of extensor tendon were found.The range of motion of the affected finger joint was significantly increased and the pain of the joint movement was alleviated.Conclusion The simple interphalangeal joint debridement through dorsal approach without cyst wall removal can avoid skin grafting and skin flap treatment.It has the advantages of low recurrence rate and good joint activity.It can be widely used in clinic.